Public Health Nutrition

Hot Topic – Nutrition for infants up to pre-school children Nutrition and health

Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008–2009

Peninah K Masiboa1 c1 and Donald Makokaa1

a1 Department of Epidemiology and Nutrition, School of Public Health, Moi University, Nairobi Campus, PO Box 63056 – 00200, Nairobi, Kenya


Objective To report on the trends and determinants of undernutrition among children <5 years old in Kenya.

Design Data from four nationwide Kenya Demographic and Health Surveys, conducted in 1993, 1998, 2003 and 2008–2009, were analysed. The Demographic and Health Survey utilizes a multistage stratified sampling technique.

Setting Nationwide covering rural and urban areas in Kenya.

Subjects The analysis included 4757, 4433, 4892 and 4958 Kenyan children aged <5 years in 1993, 1998, 2003 and 2009–2009, respectively.

Results The prevalence of stunting decreased by 4·6 percentage points from 39·9 % in 1993 to 35·3 % in 2008–2009, while underweight decreased by 2·7 percentage points from 18·7 % in 1993 to 16·0 % in 2008–2009. The effects of household wealth, maternal education and current maternal nutritional status on child nutrition outcomes have changed dynamically in more recent years in Kenya. Inadequate hygiene facilities increased the likelihood of chronic undernutrition in at least three of the surveys. Small size of the child at birth, childhood diarrhoea and male gender increased the likelihood of undernutrition in at least three of the surveys. Childhood undernutrition occurred concurrently with maternal overnutrition in some households.

Conclusions The analysis reveals a slow decline of undernutrition among young children in Kenya over the last three decades. However, stunting and underweight still remain of public health significance. There is evidence of an emerging trend of a malnutrition double burden demonstrated by stunted and underweight children whose mothers are overweight.

(Received January 17 2012)

(Revised April 30 2012)

(Accepted May 04 2012)

(Online publication June 14 2012)


c1 Corresponding author: Email